Comparative motility assessment of sperm retrieved from micro-testicular sperm extraction: A single-centre study comparing fresh and frozen-thawed sperm

Introduction: Microsurgical testicular sperm extraction (microTESE) is crucial for treating non- obstructive azoospermia (NOA), offering both 'fresh' and 'fro-zen' options. This study evaluates the impact of fresh versus frozen microTESE on the progression to intra- cytoplasmic sperm injection (ICSI) cycles, focusing on sperm motility.Materials and Methods: We conducted a retrospective analysis of microTESE pro-cedures at a major medical centre from 2007 to 2021, excluding cases of obstruc-tive azoospermia and cryptozoospermia. Patients were divided into two groups: fresh microTESE (Group FR) and frozen microTESE (Group FZ). Sperm motility was assessed, and ICSI outcomes were compared between groups.Results: Out of 128 microTESE procedures on 113 NOA patients, 31 were fresh and 97 were frozen. Sperm was found in 67.7% of fresh cases and 45.3% of frozen cases. In fresh cases, 85.7% had motile sperm for ICSI, whereas in frozen cases, 81.8% had motile sperm initially, but only 52.7% retained motility post- thaw.Conclusions: Our findings indicate a significant drop in motile sperm availability for ICSI in frozen microTESE cases compared to fresh ones. This suggests a poten-tial advantage of fresh microTESE for certain couples, despite the logistical chal-lenges, highlighting the need for careful patient selection and counselling.